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INTRODUCTION AND OBJECTIVE:Smaller number of prostate biopsy cores at cancer diagnosis may underestimate pathological characteristics of prostate cancer (PCa). We summarize clinical outcomes of PCa...

INTRODUCTION AND OBJECTIVES:No reliable biomarker is available for predicting worse clinical outcome in chemo-resistant urothelial carcinoma (UC) patients treated with pembrolizumab. We focused on ...

INTRODUCTION AND OBJECTIVES: There are few molecular markers which are known to predict a poor prognosis in upper tract urothelial carcinomas (UTUC). Axl, which is in the TAM family of receptor tyrosine kinases, has been shown to be associated with tumor progression and cancer metastasis in some types of cancer, although the association with UTUC is still not clear. We therefore investigated the biological significance of Axl on UTUC outcome. METHODS: The protein expression of Axl by immunohistochemistry and its correlation with clinicopathologic features were investigated in surgical specimens obtained from 167 patients who had been surgically treated for UTUC at our institution. The mean follow-up period was 81.8 (1-291) months. The immunoreactivity for Axl was assessed independently by a single uropathologist. RESULTS: Axl labeling was strong in 85 of 167 (55%) cases and was weak in 82 of 167 (45%) cases. Overall strong positivity of Axl expression was statistically significantly associated with high grade tumors (p1⁄40.004), positive lymphovascular invasion (LVI) (p1⁄40.001), and occurrence of postoperative metastasis (p

INTRODUCTION AND OBJECTIVES: Laparoendoscopic single-site adrenalectomy (LESS-A) has been developed as a treatment option for adrenal tumors that has cosmetic benefit and less postoperative pain. Some reports proposed that patient selection criteria should be stringent, and pheochromocytoma (PHE) should be taken as advanced indication. Here, we examined the perioperative outcomes of PHE patients who underwent laparoscopic adrenalectomy (LA), while paying special attention to any differences in surgical techniques. METHODS: The records of a total of 233 consecutive patients who underwent LA at our hospital from May 2001 to February 2012 were entered into a database. Surgical procedures were performed by two experienced laparoscopic surgeons. 1) 50 patients who underwent LA for PHE (group PHE, n 50) were compared with patients who underwent LA for other benign adrenal tumors (group non-PHE, n 183). 2) 20 consecutive patients with PHE who underwent LESS-A were compared with patients with PHE who underwent conventional LA (c-LA, n 30). RESULTS: 1) Each group was equivalent with respect to age, sex, BMI, tumor side, perioperativeiicomplication rate, and intraoperative bleeding. There were significant differences in mean size (nonPHE/PHE: 22.8 14.8 mm/46.0 21.9 mm, p 0.001) and mean pneumoperitoneum time (non-PHE/PHE: 85.3 33.0 mm/123.7 55.1 min, p 0.001) between the two groups. At least one postoperative complication (Clavien-Grade 2) occurred in 13 patients (non-PHE/PHE: 10 cases/3 cases). 2) Each group was statistically equivalent with respect to age, BMI, tumor size, operative time, intraoperative bleeding, and postoperative hospital stay. There were no significant differences in preoperative hemodynamic variables between the two groups. There were no significant differences in the highest intraoperative blood pressure (LESSA/c-LA: 161.7 7.8 mmHg/180.6 7.4 mmHg, p 0.096), hypertensive episodes (LESS-A/c-LA: 10 cases/23 cases, p 0.051), or intraoperative hypotensive episodes (LESS-A/c-LA: 4 cases/9 cases, p 0.557). In one case of LESS-A, two additional ports were added. There were 3 perioperative complications (LESS-A/c-LA: 2 cases/1 case, p 0.331). CONCLUSIONS: LA was safely performed in patients with PHE compared with that of non-PHE patients. We concluded the safety of LESS-A for PHE as being similar to that of LA. With appropriate preand intra-operative hemodynamic control and experienced hands, LESS-A could become one of the treatments of choice for resection of PHE.